THE EVALUATION VALUE OF SERUM GFAP, CRP, AND COPEPTIN COMBINED WITH MICH SCORE FOR THE PROGNOSIS OF PATIENTS WITH SPONTANEOUS CEREBRAL HEMORRHAGE

Objective: To analyze the diagnostic value of serum glial fibrillary acidic protein (GFAP), C-reactive protein (CRP), and copeptin levels combined with intracerebral hemorrhage scores (MICH) for determining the prognosis of patients with spontaneous intracerebral hemorrhage (sICH). Methods: 156 patients with sICH who were admitted to our hospital between January 2019 and January 2020 were recruited. All patients were sorted into either a death group or a survival group according to whether they died within three months. Patients in the survival group were divided according to their mRS score into a good-prognosis group (mRS < 3 points) and a poor-prognosis group (mRS = 3 points). All patients were scored according to the MICH scale immediately after admission, and 5ml of fasting venous blood was collected within 24 hours of admission. The levels of GFAP and copeptin were detected by an enzyme-linked immunosorbent assay, and CRP levels were detected by the latex immunoturbidimetric method. The serum GFAP, CRP, and copeptin levels and MICH scores of patients in the respective groups were compared. Pearsons linear correlation was used to analyze the correlations between GFAP, CRP, and copeptin levels and changes in the MICH scores, and ROC curve analysis was used to assess the combined diagnostic value of GFAP, CRP, and copeptin levels together with the MICH score for the prognostic evaluation of sICH patients. Results: The 30-day mortality rates of patients with MICH scores of 0, 1, 2, 3, 4, and 5 were 9.82%, 14.35%, 40.28%, 54.37%, and 82.21% respectively. As the 30-day mortality rate of sICH patients increased, the MICH scores increased, and when the MICH score reached and exceeded 3 points, the 30-day mortality rate increased significantly. In this experiment, the serum GFAP, CRP, and copeptin levels and the MICH scores of patients in the poor-prognosis and death groups were significantly higher than they were for those in the good-prognosis group. The serum GFAP, CRP, and copeptin levels and the MICH scores of patients in the death group were significantly higher than they were for those in the poor-prognosis group; the difference was statistically significant (P < 0.05). Pearsons linear correlation analysis showed that GFAP, CRP, and copeptin levels were significantly positively correlated with MICH scores (r values were 0.621, 0.683, and 0.759, respectively, with P < 0.01 or < 0.05). ROC curve analysis showed that the prognostic AUC of GFAP in diagnosing sICH patients was 0.772, the sensitivity was 75.26%, and the specificity was 71.05%; the prognostic AUC of CRP in diagnosing sICH patients was 0.639, the sensitivity was 60.18%, and the specificity was 65.37%; the prognostic AUC of copeptin in diagnosing sICH patients was 0.682, the sensitivity was 68.29%, and the specificity was 70.01%; the prognostic AUC of the combined serum indices in diagnosing sICH patients was 0.846, the sensitivity was 86.39%, and the specificity was 85.35%; and the prognostic AUC of the combination of serum indices with MICH scores in diagnosing sICH patients was 0.912, with a sensitivity of 90.15% and a specificity of 93.52%. Conclusion: The MICH scores of sICH patients with high mortality at 30 days were significantly increased, and the serum GFAP, CRP, and copeptin levels of sICH patients with poor prognoses were also significantly increased and significantly positively correlated with the MICH scores. The combination of the four measures has a definite value in evaluating the prognosis of sICH patients and promises to be widely useful in clinical practice.